Spontaneous cavernous sinus dural arteriovenous fistula with remote cerebellar hemorrhage: A case report

Cavernous sinus dural arteriovenous fistula (CS‑DAVF) is a rare vascular malformation that can lead to severe clinical symptoms, including ocular manifestations and intracranial hemorrhage. The current study reports a case of a spontaneous CS‑DAVF complicated by remote cerebellar hemorrhage. A 52‑year‑old man presented with nausea, vomiting and decreased appetite, with a history of hypertension but no trauma. Initially misdiagnosed with conjunctivitis, the patient showed no clinical improvement after standard treatment. Physical examination and auxiliary tests showed conjunctival congestion of the left eye with impaired ocular abduction. A subacute cerebral hemorrhage in the left cerebellar hemisphere and a left CS fistula were identified via head magnetic resonance imaging and magnetic resonance angiography. This diagnosis was confirmed by angiography, demonstrating a dural arteriovenous fistula in the CS region. Subsequently, the patient underwent DAVF interventional embolization on day 6 post‑presentation. Postoperatively, the symptoms showed notable clinical improvement, with resolution of the left conjunctival edema and restoration of normal limb movements. This case highlights the potential complications and diagnostic challenges associated with DAVFs, providing valuable clinical insights and underscoring the critical role of imaging studies in the diagnostic process. Despite the inherent limitations in generalizability associated with a single‑case study, this report provides critical clinical implications and meaningful reference for clinical practice.